Primary results of the brazilian registry of atherothrombotic disease (NEAT).

There is limited contemporary prospective real-world evidence of patients with chronic arterial disease in Latin America. The Network to control atherothrombosis (NEAT) registry is a national prospective observational study of patients with known coronary (CAD) and/or peripheral arterial disease (PAD) in Brazil. A total of 2,005 patients were enrolled among 25 sites from September 2020 to March 2022. Patient characteristics, medications and laboratorial data were collected. Primary objective was to assess the proportion of patients who, at the initial visit, were in accordance with good medical practices (domains) for reducing cardiovascular risk in atherothrombotic disease. From the total of patients enrolled, 2 were excluded since they did not meet eligibility criteria. Among the 2,003 subjects included in the analysis, 55.6% had isolated CAD, 28.7% exclusive PAD and 15.7% had both diagnoses. Overall mean age was 66.3 (± 10.5) years and 65.7% were male patients. Regarding evidence-based therapies (EBTs), 4% were not using any antithrombotic drug and only 1.5% were using vascular dose of rivaroxaban (2.5 mg bid). Only 0.3% of the patients satisfied all the domains of secondary prevention, including prescription of EBTs and targets of body-mass index, blood pressure, LDL-cholesterol, and adherence of lifestyle recommendations. The main barrier for prescription of EBTs was medical judgement. Our findings highlight that the contemporary practice does not reflect a comprehensive approach for secondary prevention and had very low incorporation of new therapies in Brazil. Large-scale populational interventions addressing these gaps are warranted to improve the use of evidence-based therapies and reduce the burden of atherothrombotic disease.ClinicalTrials.gov NCT04677725.

Non-animal protein hydrolysates from agro-industrial wastes: A prospect of alternative inputs for cultured meat.

In light of the growing demand for alternative protein sources, laboratory-grown meat has been proposed as a potential solution to the challenges posed by conventional meat production. Cultured meat does not require animal slaughter and uses sustainable production methods, contributing to animal welfare, human health, and environmental sustainability. However, some challenges still need to be addressed in cultured meat production, such as the use of fetal bovine serum for medium supplementation. This ingredient has limited availability, increases production costs, and raises ethical concerns. This review explores the potential of non-animal protein hydrolysates derived from agro-industrial wastes as substitutes for critical components of fetal bovine serum in cultured meat production. Despite the lack of standardization of hydrolysate composition, the potential benefits of this alternative protein source may outweigh its disadvantages. Future research holds promise for increasing the accessibility of cultured meat.

Evaluation of Saccharomyces cerevisiae modified via CRISPR/Cas9 as a cellulosic platform microorganism in simultaneously saccharification and fermentation processes.

The nonrenewable character and deleterious effects of fossil fuels foster the need for cleaner and more inexhaustible energy sources, such as bioethanol. Especially from lignocellulosic biomasses. However, the economic viability of this product in the market depends on process optimization and cost reduction. This research applied a sequential experimental project to investigate the process of enzymatic saccharification and simultaneous fermentation to produce ethanol with sugarcane bagasse. The differential of the work was the application of the strain of Saccharomyces cerevisiae AGY001 which was improved by evolutionary engineering to become thermotolerant and by a heterologous expression based on genomic integration by CRISPR/Cas9 to produce endoglucanase and ß-glucosidase (AsENDO-AsBGL). The maximum ethanol yield found was 89% of the maximum theoretical yield (released sugars), obtained at temperature concentrations, sugarcane bagasse and inoculum at 40 °C, 16.5%, and 4.0 g/L, respectively (12.5 FPU/g bagasse). The mathematical model obtained can predict approximately 83% of the data set with 95% confidence. Therefore, these findings demonstrated the potential of sugarcane bagasse and S. cerevisiae AGY001 strain (CRISPR/Cas9 modified) in bioethanol production without the need for impractical selection media on an industrial scale, in addition to providing useful insights for the development of SSF processes.

Unwrapping broken tails: Biological and environmental correlates of predation pressure in limbless reptiles.

Studying species interactions in nature often requires elaborated logistics and intense fieldwork. The difficulties in such task might hinder our ability to answer questions on how biotic interactions change with the environment. Fortunately, a workaround to this problem lies within scientific collections. For some animals, the inspection of preserved specimens can reveal the scars of past antagonistic encounters, such as predation attempts. A common defensive behaviour that leaves scars on animals is autotomy, the loss of a body appendage to escape predation. By knowing the collection site of preserved specimens, it is possible to assess the influence of organismal biology and the surrounding environment in the occurrence of autotomy. We gathered data on tail loss for 8189 preserved specimens of 33 snake and 11 amphisbaenian species to investigate biological and environmental correlates of autotomy in reptiles. We applied generalized linear mixed effect models to evaluate whether body size, sex, life-stage, habitat use, activity pattern, biome, tropicality, temperature and precipitation affect the probability of tail loss in limbless reptiles. We observed autotomy in 23.6% of examined specimens, with 18.7% of amphisbaenian and 33.4% of snake specimens showing tail loss. The probability of tail loss did not differ between snakes and amphisbaenians, but it was higher among large-sized specimens, particularly in adults and females. Chance of tail loss was higher for diurnal and arboreal species, and among specimens collected in warmer regions, but it was unaffected by biome, precipitation, and tropicality. Autotomy in limbless reptiles was affected by size-dependent factors that interplay with ontogeny and sexual dimorphism, although size-independent effects of life-stage and sex also shaped behavioural responses to predators. The increase in probability of tail loss with verticality and diurnality suggests a risk-balance mechanism between species habitat use and activity pattern. Although autotomy is more likely in warmer regions, it seems unrelated to seasonal differences in snakes and amphisbaenians activity. Our findings reveal several processes related to predator-prey interactions involving limbless reptiles, demonstrating the importance of scientific collections to unveil ecological mechanisms at different spatio-temporal scales.

Treatment With Methotrexate Associated With Lipid Core Nanoparticles Prevents Aortic Dilation in a Murine Model of Marfan Syndrome.

In Marfan syndrome (MFS), dilation, dissection, and rupture of the aorta occur. Inflammation can be involved in the pathogenicity of aortic defects and can thus be a therapeutic target for MFS. Previously, we showed that the formulation of methotrexate (MTX) associated with lipid nanoparticles (LDE) has potent anti-inflammatory effects without toxicity. To investigate whether LDEMTX treatment can prevent the development of aortic lesions in the MFS murine model. MgΔloxPneo MFS (n = 40) and wild-type (WT, n = 60) mice were allocated to 6 groups weekly injected with IP solutions of: (1) only LDE; (2) commercial MTX; (3) LDEMTX (dose = 1mg/kg) between 3rd and 6th months of life. After 12 weeks of treatments, animals were examined by echocardiography and euthanatized for morphometric and molecular studies. MFS mice treated with LDEMTX showed narrower lumens in the aortic arch, as well as in the ascending and descending aorta. LDEMTX reduced fibrosis and the number of dissections in MFS but not the number of elastic fiber disruptions. In MFS mice, LDEMTX treatment lowered protein expression of pro-inflammatory factors macrophages (CD68), T-lymphocytes (CD3), tumor necrosis factor-α (TNF-α), apoptotic factor cleaved-caspase 3, and type 1 collagen and lowered the protein expression of the transforming growth factor-ß (TGF-ß), extracellular signal-regulated kinases ½ (ERK1/2), and SMAD3. Protein expression of CD68 and CD3 had a positive correlation with an area of aortic lumen (r 2 = 0.36; p < 0.001), suggesting the importance of inflammation in the causative mechanisms of aortic dilation. Enhanced adenosine availability by LDEMTX was suggested by higher aortic expression of an anti-adenosine A2a receptor (A2a) and lower adenosine deaminase expression. Commercial MTX had negligible effects. LDEMTX prevented the development of MFS-associated aortic defects and can thus be a candidate for testing in clinical studies.

Use of paclitaxel carried in solid lipid nanoparticles to prevent peritoneal fibrosis in rats.

BACKGROUND: Progressive fibrous thickening of peritoneal membrane (PM) is a major complication of long-term peritoneal dialysis. TGF-ß/SMAD pathway activation, inflammation and neoangiogenesis have an important role in PM changes induced by peritoneal dialysis. Here, we investigated the effects of paclitaxel (PTX) carried in lipid core nanoparticles (LDE) on the development of peritoneal fibrosis (PF) in rats. METHODS: To induce PF, 21 male Wistar rats (300-350g) were injected with chlorhexidine gluconate for 15 consecutive days and randomly assigned to three groups: 1)PF, n = 5: no treatment; 2)LDE, n = 8: treated with LDE only, 3/3 days during 15 days; 3)LDE-PTX, n = 8: treated with PTX (4mg/kg) associated with LDE, 3/3 days during 15 days. A Control group without PF induction (n = 5) was designed, received saline solution, 3/3 days. Peritoneum function tests were performed, and anterior abdominal wall samples of the PM were collected for analyses of peritoneal thickness, immunohistochemitry, and gene expression. RESULTS: LDE-PTX treatment preserved the membrane function, maintaining the ultrafiltration rate and mass transfer of glucose at normal levels. LDE-PTX also prevented PM thickening induced by chlorhexidine gluconate injections. LDE-PTX treatment reduced the number of myofibroblasts infiltrating PM and inhibited the cell proliferation. Gene expression of fibronectin, FSP-1, VEGF, TGF-ß, and SMAD3 were reduced by LDE-PTX. CONCLUSIONS: LDE-PTX was effective to prevent development of PF and preserve the PM filtration capacity in this rat model, with clear-cut actions on pro-fibrotic mechanisms. Thus, LDE-PTX can be candidate for future clinical trials as adjuvant to peritoneal dialysis to prevent PF development, since this preparation is devoid of toxicity as shown previously.

Entomofauna study of bean genotypes by multivariate analysis / Estudio de la entomofauna de genotipos de frijol por medio de análisis multivariado

RESUMEN En el cultivo del frijol existen diversas especies de insectos que pueden ocasionar perjuicios a la productividad y enemigos naturales que pueden ayudar a regular sus poblaciones. El objetivo del presente estudio fue evaluar la entomofauna asociada a 20 genotipos de frijol y correlacionar la interacción entre los insectos utilizando análisis multivariado. Las especies más abundantes en el sistema estudiado fueron Sternechus subsignatus (Curculionidae: Sternechini), Euschistus heros (Hemiptera: Pentatomidae) y Diabrotica speciosa (Coleoptera: Chrysomelidae). Las tres especies presentaron correlación directa entre sí. El cultivo del frijol en estudio presentó tres especies de chinches consideradas importantes plagas. Las especies Cerotoma arcuata (Coleoptera: Chrysomelidae) y Edessa meditabunda meditabunda (Hemiptera: Pentatomidae) presentaron correlación inversa entre sí.

ABSTRACT There are several species of insects that can cause damage to productivity and natural enemies that can help to regulate populations in beans cultivation. The objective of the present study was to evaluate the entomofauna associated with 20 bean genotypes and correlate the interaction between insects using multivariate analysis. The most abundant species in the studied system were Sternechus subsignatus Boheman, 1836 (Curculionidae: Sternechini), Euschistus heros (Hemiptera: Pentatomidae), and Diabrotica speciosa (Coleoptera: Chrysomelidae). All three species showed direct correlation with each other. The bean crop under study presented three species of stinkbugs considered important pests. The species Cerotoma arcuata (Coleoptera: Chrysomelidae) and Edessa meditabunda (Hemiptera: Pentatomidae) presented inverse correlation with each other.

Epidemiology of snake envenomation from Mato Grosso do Sul, Brazil.

Snake envenomation is considered a public health problem in tropical countries, where they occur in a high incidence. The present study reports the snake envenomation that occurred in Mato Grosso do Sul state (Brazil) between 2007 and 2017. Epidemiological data were obtained from the online platform of the Notification Disease Information System and were analyzed according to biome. A total of 5568 cases of snake envenomations were recorded during the study period, where the highest frequency was registered between October and April. The majority of envenomations occurred in working-age males (20 to 39 years), caused mainly by Bothrops snakes, and the duration of care after the envenomation in most cases took three hours. The municipalities that showed the highest snake envenomations case per 100,000 inhabitants presents low population density, and have their economy based on agricultural activity, which is a risk factor to snake envenomations. To the Mato Grosso do Sul state, the total number of snake envenomations had a positive relationship with the size of the municipality. Since this, larger areas usually have a mosaic of environments, which may harbor higher richness and abundance of snakes, and can cause more snake encounters with the population, resulting in more snake envenomations.

Noninvasive Neuromodulation Techniques in Difficult Tracheostomy Weaning of Patients With Spinal Cord Injury: Report of Two Cases.

High spinal cord injured patients (SCI) are susceptible to respiratory muscle impairments. Transcranial direct current stimulation (tDCS) and peripheral electrical stimulation (PES) may influence the diaphragm's central control, but until now they are not described as a therapeutic resource for difficult weaning. We present two case reports of SCI patients (P1 and P2) with long-term tracheostomy (>40 days) and hospital stay (>50 days). In association with respiratory exercise, P1 received a combined application of anodal tDCS over the supplementary motor area plus sensory PES in the thoracic-abdominal muscles, and P2 received isolated excitatory PES in the abdominal muscles, applied daily except on weekends. Maximum inspiratory/expiratory pressure, peak cough flow, diaphragm excursion, and thickening fraction were measured in the first and last days of the protocol. Both patients had improvements, with clinical impact such as cough effectiveness, decannulated after 15 applications of stimulation. Augmentation of neural respiratory drive and corticospinal excitability is suggested.

Immobilization of Serratia plymuthica by ionic gelation and cross-linking with transglutaminase for the conversion of sucrose into isomaltulose.

Isomaltulose is an alternative sugar obtained from sucrose using some bacteria producing glycosyltransferase. This work aimed to optimize conditions for the immobilization of Serratia plymuthica through ionic gelation and cross-linking by transglutaminase using the sequential experimental strategy for the conversion of sucrose into isomaltulose. The effect of five variables (concentrations of cell mass, alginate, gelatin, transglutaminase, and calcium chloride) was studied, as well as the interactions between them on the matrix composition for the S. plymuthica immobilization. Three experimental designs were used to optimize the concentrations of each variable to obtain higher concentration of isomaltulose. A high conversion of sucrose into isomaltulose (71.04%) was obtained by the cells immobilized in a matrix composed of alginate (1.7%), CaCl2 (0.25 mol/L), gelatin (0.5%), transglutaminase (3.5%) and cell mass (33.5%). As a result, the transglutaminase application as a cross-linking agent improved the immobilization of Serratia plymuthica cells and the conversion of sucrose into isomaltulose.

Competências essenciais de promoção da saúde na formação do enfermeiro: revisão integrativa / Competencias esenciales de promoción de la salud en la formación del enfermero: revisión integradora / Essential health promotion competencies in nursing training: an integrative review

Resumo Objetivo: Analisar evidências disponíveis na literatura sobre as competências essenciais de promoção da saúde relacionadas ao Projeto, "Desenvolvendo competências e padrões profissionais para a construção da capacidade em promoção da saúde na Europa" (CompHP), na formação do enfermeiro no contexto brasileiro. Métodos: Revisão integrativa de literatura nas bases de dados PUBMED, Web of Science , CINAHL, LILACS, BDENF e Biblioteca Eletrônica Scielo, com descritores "Enfermagem", "Promoção da Saúde" e palavras-chave "Competências" e "CompHP". Foram elegíveis artigos publicados a partir de 2011, nos idiomas português, inglês e espanhol. A questão norteadora e as buscas nas bases de dados ocorreram a partir da Estratégia PVO. Resultados: Seis publicações foram incluídas, sendo estabelecidas duas categorias temáticas: Desenvolvimento de Competências do CompHP na formação do enfermeiro; Ensino das Competências de Promoção da Saúde. As competências do CompHP têm sido desenvolvidas durante a formação do enfermeiro, contudo, apenas três delas com regularidade: Possibilidade de mudança; Parceria e Liderança. Conclusão: Este estudo amplia a compreensão sobre como alguns processos relacionados ao CompHP têm sido incorporados à formação de enfermeiros, além de versar sobre sua importância para a formação crítica e reflexiva a partir da incorporação das competências essenciais no currículo de cursos de graduação de enfermagem no cenário brasileiro.

Resumen Objetivo: Analizar las evidencias disponibles en la literatura sobre las competencias esenciales de promoción de la salud relacionadas con el proyecto "Desarrollo de competencias y criterios profesionales en la construcción de capacidades para la promoción de la salud en Europa" (CompHP) en la formación del enfermero en el contexto brasileño. Métodos: Revisión integradora de literatura en las bases de datos PUBMED, Web of Science , CINAHL, LILACS, BDENF y Biblioteca Electrónica Scielo, con descriptores "Enfermería", "Promoción de la salud" y palabras clave "Competencias" y "CompHP". Los artículos elegibles fueron los publicados a partir de 2011, en portugués, inglés y español. La pregunta orientadora y las búsquedas en las bases de datos se realizaron siguiendo la estrategia PVO. Resultados: Se incluyeron seis publicaciones y se establecieron dos categorías temáticas: Desarrollo de competencias del CompHP en la formación del enfermero; Enseñanza de las competencias de promoción de la salud. Las competencias del CompHP fueron desarrolladas durante la formación del enfermero, sin embargo, solo tres de ellas con regularidad: Posibilidad de cambio, Colaboración y Liderazgo. Conclusión: Este estudio amplía la comprensión sobre cómo algunos procesos relacionados con el CompHP fueron incorporados a la formación de enfermeros, además de abordar su importancia para la formación crítica y reflexiva a partir de la incorporación de las competencias esenciales en el diseño curricular de carreras de grado de enfermería en el escenario brasileño.

Abstract Objective: to analyze the evidence available in the literature on essential health promotion competencies related to Developing Competencies and Professional Standards for Health Promotion Capacity Building in Europe (CompHP) project, in nursing training in the Brazilian context. Methods: this is an, integrative literature review in the PUBMED, Web of Science, CINAHL, LILACS, BDENF and Scielo Electronic Library databases, with descriptors "Nursing", "Health Promotion" and keywords "Competencies" and "CompHP". Articles published since 2011, in Portuguese, English and Spanish were eligible. The guiding question and the searches in the databases occurred from PVO strategy. Results: six publications were included, with two thematic categories being established: Development of CompHP Competencies in nursing training; Teaching Health Promotion Competencies. CompHP competencies have been developed during nursing training; however, only three of them regularly: enable change, mediation through partnership and leadership. Conclusion: this study expands the understanding of how some processes related to CompHP have been incorporated into nursing training, in addition to addressing their importance for critical and reflective training from the incorporation of essential competencies in the curriculum of undergraduate nursing courses in the Brazilian setting.

Applications of Non-invasive Neuromodulation for the Management of Disorders Related to COVID-19.

Background: Novel coronavirus disease (COVID-19) morbidity is not restricted to the respiratory system, but also affects the nervous system. Non-invasive neuromodulation may be useful in the treatment of the disorders associated with COVID-19. Objective: To describe the rationale and empirical basis of the use of non-invasive neuromodulation in the management of patients with COVID-10 and related disorders. Methods: We summarize COVID-19 pathophysiology with emphasis of direct neuroinvasiveness, neuroimmune response and inflammation, autonomic balance and neurological, musculoskeletal and neuropsychiatric sequela. This supports the development of a framework for advancing applications of non-invasive neuromodulation in the management COVID-19 and related disorders. Results: Non-invasive neuromodulation may manage disorders associated with COVID-19 through four pathways: (1) Direct infection mitigation through the stimulation of regions involved in the regulation of systemic anti-inflammatory responses and/or autonomic responses and prevention of neuroinflammation and recovery of respiration; (2) Amelioration of COVID-19 symptoms of musculoskeletal pain and systemic fatigue; (3) Augmenting cognitive and physical rehabilitation following critical illness; and (4) Treating outbreak-related mental distress including neurological and psychiatric disorders exacerbated by surrounding psychosocial stressors related to COVID-19. The selection of the appropriate techniques will depend on the identified target treatment pathway. Conclusion: COVID-19 infection results in a myriad of acute and chronic symptoms, both directly associated with respiratory distress (e.g., rehabilitation) or of yet-to-be-determined etiology (e.g., fatigue). Non-invasive neuromodulation is a toolbox of techniques that based on targeted pathways and empirical evidence (largely in non-COVID-19 patients) can be investigated in the management of patients with COVID-19.

A morphological and molecular study of Hydrodynastes gigas (Serpentes, Dipsadidae), a widespread species from South America.

BACKGROUND: Studies with integrative approaches (based on different lines of evidence) are fundamental for understanding the diversity of organisms. Different data sources can improve the understanding of the taxonomy and evolution of snakes. We used this integrative approach to verify the taxonomic status of Hydrodynastes gigas (Duméril, Bibron & Duméril, 1854), given its wide distribution throughout South America, including the validity of the recently described Hydrodynastes melanogigas Franco, Fernandes & Bentim, 2007. METHODS: We performed a phylogenetic analysis of Bayesian Inference with mtDNA 16S and Cytb, and nuDNA Cmos and NT3 concatenated (1,902 bp). In addition, we performed traditional morphometric analyses, meristic, hemipenis morphology and coloration pattern of H. gigas and H. melanogigas. RESULTS: According to molecular and morphological characters, H. gigas is widely distributed throughout South America. We found no evidence to support that H. gigas and H. melanogigas species are distinct lineages, therefore, H. melanogigas is a junior synonym of H. gigas. Thus, the melanic pattern of H. melanogigas is the result of a polymorphism of H. gigas. Melanic populations of H. gigas can be found in the Tocantins-Araguaia basin.

Richness, diversity patterns, and taxonomic notes of amphibians from the Tocantins state / Riqueza, padrões de diversidade e notas taxonômicas dos anfíbios do estado do Tocantins

Abstract: Herein, we provide the first comprehensive amphibian checklist for the State of Tocantins, North of Brazil, based on field sampling, literature data, and specimens deposited in zoological collections. We performed field surveys from 2012 to 2019 in 12 Tocantins municipalities, totaling 376 days of sampling effort. We analyzed 25 papers from the literature and examined 1311 specimens from collections and collected 750 during field surveys. We recorded 90 amphibian species distributed in 12 anurans and two caecilians families. At least seven undescribed species along the state were recorded. We also present new records for 20 species for the state, nine of them corresponding to Amazonian species, four Cerrado endemic, one Caatinga species, and the widely distributed treefrog Boana crepitans; the others five new records comprise undescribed species. Our data also suggest that the Tocantins amphibian composition is not geographically structured in relation to the biomes, since Amazonian, Caatinga, and Cerrado amphibian lineages have their distribution nearly completely overlapped in the state. We propose that this absence of spatial structuration may be a result of two factors (synergetic or not). First, the events of expansion and retraction of the biomes caused by the Quaternary climatic cycles, which may have mixed the populations of species from different biomes causing the notable pattern of overlapped distribution observed here. Second, the forest environments (e.g. gallery and riparian forests) associated to the Araguaia-Tocantins River basins may have acted as historical dispersal corridors for the Amazonian amphibian lineages into the Cerrado of the Tocantins. Despite the sampling effort of the present study, we stress that gaps of information still remain and further field sampling efforts should be performed along the state. Lastly, taxonomic appraisals involving the species with problematic taxonomic status recorded here should be based on multiples lines of evidences (acoustic, molecular, and morphological data), which will render a more accurate view on the Tocantins amphibian diversity. Such data are extremely necessary under the current high rate of habitat loss across the state, since they can be used to guide public policies of conservation.

Resumo: Apresentamos aqui a primeira lista de anfíbios para o estado do Tocantins, região norte do Brasil, com base em amostragens de campo, dados da literatura e espécimes depositados em coleções zoológicas. As expedições de campo foram realizadas entre 2012 e 2019 em 12 municípios do Tocantins, totalizando 376 dias de esforço amostral. Nós analisamos 25 artigos da literatura, examinamos 1311 espécimes depositados em coleções e coletamos 750 indivíduos durante as amostragens de campo. No total, nós registramos 90 espécies de anfíbios distribuídas em 14 famílias, das quais 12 são de anuros e duas são de gimnofionas. Nossas amostragens também indicam a presença de ao menos sete espécies não descritas ao longo do estado. Adicionalmente, fornecemos registros inéditos para 20 espécies, das quais nove são amazônicas, quatro são endêmicas do Cerrado, uma espécie da Caatinga e uma amplamente distribuída, a perereca Boana crepitans; cinco das espécies cujos os registros são inéditos para o estado correspondem a linhagens não descritas. Nossos dados também sugerem que a fauna de anfíbios do Tocantins não está geograficamente estruturada em relação aos biomas, uma vez que linhagens de anfíbios amazônicos, da Caatinga e endêmicas do Cerrado apresentaram distribuição quase completamente sobreposta ao longo de todo o estado. Nós propomos que essa ausência de estruturação espacial pode ser o resultado de dois fatores (sinergéticos ou não). Primeiro, os eventos de expansão e retração dos biomas causados pelos ciclos climáticos do quaternário, que podem ter mixado as populações de espécies de diferentes biomas, promovendo o padrão de sobreposição de distribuição geográfica aqui observado. Segundo, destacamos que os ambientes florestais (e.g. matas de galeria e ripárias) associadas às bacias do dos Rios Araguaia-Tocantins podem ter atuado como corredores históricos de dispersão para linhagens de anfíbios amazônicos para dentro do Cerrado tocantinense. A despeito do esforço de amostragem do presente estudo, lacunas de informação em diversas áreas do estado permanecem e apontam a necessidade de adicionais amostragens de campo. Além disso, diversas espécies com status taxonômico problemático foram diagnosticadas no presente estudo, e futuras avaliações das mesmas devem ser baseadas em múltiplas linhas de evidência (dados acústicos, moleculares e morfológicos), produzindo assim uma visão mais acurada sobre a diversidade de anfíbios do estado do Tocantins. Essas informações são extremamente necessárias em vista das atuais taxas de degradação ambiental dentro do estado do Tocantins, uma vez que esse tipo de informação pode auxiliar políticas públicas voltadas para conservação.

Doadores de sangue envelhescentes e idosos: prevalência e reações adversas / Aging and elderly blood donors: prevalence and adverse reactions / Envejecimiento y donantes de sangre elderly: prevalencia y reacciones adversas

Verificou-se a prevalência e reações adversas às doações de sangue em doadores envelhescentes e idosos. Estudo retrospectivo, com dados do sistema informatizado de Hemocentro em Brasília. Do total de 55636 doadores, 6,3% eram envelhescentes; e 0,8%, idosos. Houve menor prevalência de reações adversas nos idosos, sem diferença significativa. Quanto à intensidade das reações, foram leves nos idosos, leves e moderados nos envelhescentes, também sem diferença significativa.

Prevalence and adverse reactions to blood donations were found in aging and elderly donors. Retrospective study with data from the computerized system of Hemocenter in Brasília. Of the 55636 donors, 6.3% were aging and 0.8% elderly. There was a lower prevalence of adverse reactions in the elderly, with no significant difference. Regarding the intensity of the reactions, they were mild in the elderly, mild and moderate in the aging, also without significant difference.

La prevalencia y las reacciones adversas a las donaciones de sangre se encontraron en donantes envejecimiento y ancianos. Estudio retrospectivo con datos del sistema computarizado de Hemocentro en Brasilia. De los 55636 donantes, 6.3% estaban envejeciendo y 0.8% ancianos. Hubo una menor prevalencia de reacciones adversas en los ancianos, sin diferencias significativas. En cuanto a la intensidad de las reacciones, fueron leves en los ancianos, leves y moderados en el envejecimiento, también sin diferencias significativas.

Nanotechnology for the treatment of deep endometriosis: uptake of lipid core nanoparticles by LDL receptors in endometriotic foci.

OBJECTIVE: Rapidly dividing cells in multiple types of cancer and inflammatory diseases undergo high low density lipoprotein (LDL) uptake for membrane synthesis, and coupling an LDL-like nanoemulsion, containing lipid nanoparticles (LDE) to a chemotherapeutic agent efficiently targets these cells without significant systemic effects. This was a prospective exploratory study that evaluated the uptake of a radioactively labeled LDE emulsion by receptors of endometriotic foci and the capacity of the LDE for cellular internalization. METHODS: The lipid profile of each patient was determined before surgery, and labeled LDE were injected into fourteen patients with intestinal or nonintestinal endometriosis. The radioactivity of each tissue sample (intestinal endometriosis, nonintestinal endometriosis, healthy peritoneum, or topical endometrium) was measured. RESULTS: The group with intestinal endometriosis presented higher levels of plasma LDL but lower LDE uptake by foci than the nonintestinal group, suggesting less cell division and more fibrosis. The uptake of LDE was highest in the topical endometrium, followed by the healthy peritoneum, and lowest in the endometriotic lesion. Since the endometriotic foci showed significant LDE uptake, there was likely increased consumption of LDL by these cells, similar to cells in cancers and inflammatory diseases. Plasma cholesterol levels had no influence on LDE uptake, which showed that the direct delivery of the nanoemulsion to target tissues was independent of serum lipoproteins. There were no significant differences in the parameters (p>0.01) because of the small sample size, but the findings were similar to those of previous studies. CONCLUSION: Nanotechnology is a promising therapeutic option for surgery and hormonal blockage for deep endometriosis, with a lower complication rate and no systemic side effects.

Conhecimento e atitudes da equipe de enfermagem sobre cateter com dispositivo seguro em um hospital brasileiro / Nursing staff knowledge and attitudes about safe device catheters in a Brazilian hospital / Conocimientos y actitudes del personal de enfermería sobre catéteres de dispositivos seguros en un hospital brasileño

Objetivo: descrever o conhecimento e atitudes dos profissionais de enfermagem sobre um Dispositivo Seguro com Controle de Engenharia. Método: estudo transversal descritivo, realizado em um hospital público brasileiro, especializado para o tratamento de HIV/aids. Foram entrevistados profissionais de enfermagem no período de maio a julho de 2015. Os dados foram analisados por meio da estatística descritiva e inferencial. Resultados: dos 180 entrevistados, 72,2% não participaram de treinamento que propiciava conhecimento para o uso do cateter com dispositivo de segurança. Quanto às atitudes de risco, a reinserção de um mesmo cateter periférico antes de acionar a proteção da agulha, em mais de uma punção, no mesmo paciente foi citada como prática rotineira por 48 (26,7%) participantes. Conclusão: a maioria dos profissionais de enfermagem não recebeu treinamentos para uso de dispositivos, mas reconheceu características e mecanismos de proteção contra picada de agulha e contato com sangue.

Objective: describing the knowledge and attitudes of nursing professionals regarding a Safe Device with Engineered Controls. Methods: cross-sectional descriptive study, carried out in a Brazilian general hospital, specialized in the treatment of HIV/aids. Nursing professionals were interviewed from May to July 2015. Data was analyzed using descriptive and inferential statistics. Results: from the 180 interviewees, 72.2% did not participate in any training that offered knowledge about the use of the catheter with a safety device. Regarding the risk attitudes, reinserting the same peripheral catheter before activating the needle protection, in more than one puncture, in the same patient, was mentioned as a routine practice by 48 (26.7%) participants. Conclusion: most nursing professionals did not receive training in the use of the devices but could recognize characteristics and mechanisms of protection against needle punctures and contact with blood.

Objetivo: describir el conocimiento y las actitudes de los profesionales de enfermería sobre un Dispositivo de Seguridad con Controlo de Ingeniería. Método: estudio trasversal descriptivo, conducido en un hospital público brasileño, especializado en el tratamiento de HIV/sida. Se entrevistó profesionales de enfermería de mayo a julio de 2015. Se analizó a los datos utilizando estadística descriptiva e inferencial. Resultados: 72.2% de los 180 entrevistados no participaron de ningún entrenamiento sobre el uso del catéter con dispositivo de seguridad. Con respecto a las actitudes de riesgo, la reinserción del mismo catéter periférico antes de accionar la protección de la aguja, en más de una punción, en el mismo paciente, fue citada como práctica común por 48 (26.7%) de los participantes. Conclusión: la mayoría de los profesionales de enfermería no recibió entrenamiento para utilizar los dispositivos, pero reconoció características y mecanismos de protección contra pinchazos y contacto con la sangre.

Desenvolvimento do mapa estratégico como diretriz de gestão em serviço de fisioterapia hospitalar / Development of a strategic map as a management guideline in hospital-based physiotherapy

Trata-se de um relato de caso abordando a experiência de um projeto de gestão desenvolvido na Divisão de Fisioterapia do Instituto Central do Hospital das Clí­nicas da Faculdade de Medicina da Universidade de São Paulo. A gestão de serviços de saúde é complexa e desafiadora, devido a fatores como as constantes transformações tecnológicas e terapêuticas, aumento da população idosa e de doenças crônicas, escassez de recursos e carência de gestão eficiente nas organizações. A definição de objetivos, estratégias e instrumentos de monitoramento para direcionar a organização e promover qualidade são determinantes nas ações gerenciais e no desempenho estratégico da empresa. Neste contexto, o projeto objetivou construir um mapa estratégico considerando o Balanced ScoreCard como diretriz gerencial e instrumento de análise do desempenho da Divisão de Fisioterapia. Reuniões estruturadas com membros da liderança de fisioterapia foram realizadas para definir a visão do futuro e objetivos estratégicos a médio e longo prazo, idealizados pela Divisão de Fisioterapia, tendo como base as perspectivas do Balanced ScoreCard, aprendizado e crescimento, processos internos, clientes, sustentabilidade financeira e social. O mapa estratégico foi construí­do em uma representação gráfica permitindo fácil compreensão da visão do futuro e objetivos estratégicos que irão direcionar o comportamento e o desempenho da Divisão de Fisioterapia, nos próximos anos. Além de direcionar as ações de melhorias da Divisão, o mapa estratégico elaborado também apresenta caracterí­sticas marcantes de alinhamento com o mapa estratégico institucional. (AU)

This is a case report addressing a management project developed in the Physiotherapy Division of the Central Institute of Hospital das Clínicas, Faculty of Medicine, University of São Paulo. Managing health services is complex and challenging due to factors such as constant technological and therapeutic changes, increase in the elderly population and chronic diseases, scarcity of resources, and lack of efficient organizational management. The definition of objectives, strategies, and monitoring tools to direct the organization and promote quality help to determine managerial actions and the strategic performance of the service. In this context, this project aimed to build a strategic map using the Balanced Scorecard as a managerial guideline and instrument of performance analysis for the Physiotherapy Division. Structured meetings with members of the physiotherapy leadership team were held to define the vision for the future and strategic medium - and long-term objectives. The strategic map was built as a graphical representation, allowing for easy understanding of the vision for the future and strategic objectives that will guide the behavior and performance of the Physiotherapy Division in the coming years. In addition to directing the improvement actions of the division, the strategic map also presents striking instances of alignment with the institutional strategic map.(AU)

Hypertonic Saline Solution Reduces Microcirculatory Dysfunction and Inflammation in a Rat Model of Brain Death.

BACKGROUND: Brain death (BD) induces hemodynamic instability with microcirculatory hypoperfusion, leading to increased organ inflammation and dysfunction. This study investigated the effects of 7.5% hypertonic saline solution (HSS) on mesenteric microcirculatory dysfunction and inflammation in a rat model of BD. METHODS: Male Wistar rats were anesthetized and mechanically ventilated. BD was induced by rapidly inflating an intracranial balloon catheter. The rats were randomly divided into: SH, sham-operated rats subjected to trepanation; NS, rats treated with NaCl 0.9%, 4 mL/kg immediately after BD; T1, rats treated with HSS (NaCl 7.5%, 4 mL/kg) immediately or 60 min after BD, T60. All groups were analyzed 180 min after the start of the experiment. RESULTS: Rats in BD groups presented with a similar hypertensive peak, followed by hypotension. Proportion of perfused small vessels was decreased in the NS group (46%) compared with the SH group (74%, P = 0.0039). HSS restored the proportion of perfused vessels (T1 = 71%, P = 0.0018). The anti-endothelial nitric oxide synthase (eNOS) protein expression significantly increased in rats given HSS (T1, and T60, P = 0.0002). Similar results were observed regarding endothelin-1 (P < 0.0001). Increased numbers of rolling (P = 0.0015) and migrated (P = 0.0063) leukocytes were observed in the NS group compared with the SH group. Rats given HSS demonstrated an overall reduction in leukocyte-endothelial interactions. The ICAM-1 levels increased in the NS group compared with the SH group, and decreased in the HSS-treated groups (P = 0.0002). CONCLUSIONS: HSS may improve the density of mesenteric perfused small vessels due to its effects on eNOS and endothelin-1 protein expression, and reduces inflammation by decreasing leukocyte adhesion and migration in a rat model of BD.